National monitoring and evaluation of eHealth: a scoping review

Objective: There has been substantial growth in eHealth over the past decade, driven by expectations of improved healthcare system performance. Despite substantial eHealth investment, little is known about the monitoring and evaluation strategies for gauging progress in terms of eHealth availability and use. This scoping review aims to map the existing literature and depict the predominant approaches and methodological recommendations to national and regional monitoring and evaluation of eHealth availability and use in order to advance national strategies for monitoring and evaluating eHealth.
Methods: Peer-reviewed and grey literature on monitoring and evaluation of eHealth availability and use, published between January 1st, 2009, to March 11th, 2019, were eligible for inclusion. 2,354 publications were identified, and 36 publications were included after full-text review. Data on publication type (e.g. empirical research), country, level (national or regional), publication year, method (e.g. survey), and domain (e.g., Provider-centric electronic record) was charted.
Results: The majority of publications monitored availability alone or applied a combination of availability and use measures. Surveys were the most common data collection method (used in 86% of the publications). OECD, European Commission, Canada Health Infoway, and WHO have developed comprehensive eHealth monitoring and evaluation methodology recommendations.
Discussion: Establishing continuous national eHealth monitoring and evaluation, based on international approaches and recommendations, could improve the ability for cross-country benchmarking and learning. This scoping review provides an overview of the predominant approaches and recommendations to national and regional monitoring and evaluating eHealth and thereby provides a starting point for developing national eHealth monitoring strategies.